LOCATION: TAMPA, FLORIDA
CONTRACT: 1ST SHIFT
Validation and pursuit of underpaid hospital accounts via web portals, payer packages (bulk claim submissions), and phone collections. Submission of written disputes/appeals of underpaid accounts, as well as coordination with clinical staff for medical denial disputes/appeals. Balancing appropriate collections follow up with new incoming inventory validation/pursuit, as well as providing appropriate documentation and progressive action stepping for account resolutions and revenue generation.
Key Job Responsibilities
Research and review facility systems/remits to determine Clients' actions/due diligence taken on underpaid/denial claims, as well as payers' processing responses and outcomes.
Actively validate, pursue and collect on denials and underpaid accounts utilizing web portals, payer packages (bulk claim submissions), and phone collections.
Accurately write and submit hospital claim underpayment and denial disputes to insurance companies.
Provide proper and accurate documentation and action updates into various systems.
Monitor inventory volumes and provide timely account follow-up.
Prioritize workloads using use tools and resources in the most efficient manner to produce the highest levels of Revenue.
Knowledge, Skills & Abilities:
Strong decision making and problem-solving skills are needed, coupled with an ability to work independently with minimal supervision.
Knowledge of CPT-4/HCPC/DRG/ICD/HCPCs, and Revenue codes
Simple sorting and filtering in Excel skills required
Familiarity with HIPAA privacy guidelines as well as maintaining and protecting all confidential information.
Ability to multitask and set priorities on multiple projects for the highest rate of returns.
High school diploma or GED required
2 years insurance company collections experience, preferably with hospital claims preferred, or prior hospital revenue cycle experience with hospital patient accounting systems and processes knowledge. Previous experience as a Medical Reimbursement Specialist, Healthcare Insurance Collector, Hospital Patient Account Representative, Medical Claims Processor, Insurance Company Provider or Customer Service Representative, or related experience is a plus.
Please submit resume to email@example.com
Sedona Staffing Services is an Equal Opportunity Employer